nightmare clinical experiences

[kss0740]

i'm a block 1 student and recently started at my second clinical site. i'm a newbie to the program & to clinicals, and am hoping i can get some insight (and encouragement!) into process. right now i'm very concerned that i'm learning more of what not to do than rather what to do. granted, this is teaching about good care vs bad, and what kind of nurse i want to be vs what i don't....... however, i'm worried that i'm simply not getting the good clinical, hands on experience that i'd like to take with me into my nursing career.

so far, what i've seen at my 2 clinical sites has been disturbing. we are working at care homes & a rehab facility, and the nursing care is simply awful. at the first care home, i found that sinks almost never had soap by them, nurses let patients sit in soiled briefs for hours, and med errors were made all the time (crushing up enteric coated meds, extended release meds, etc)

the last time i was at my current clinical site (a rehab facility that has a good reputation- i won't mention names here) i watched an rn try to straight cath a woman 5 times over an hour. the poor patient was crying. after getting the cath partway up the poor woman's lady parts several times, she would withdraw it and start over with the same catheter. unsterile- yuck. and did i mention she wasn't using any lube? i never saw her successfully find the correct opening, and seriously wonder if she thought the lady parts was where you are supposed to put a catheter. i asked the nurse if she wanted me to run outside and get somebody else, she declined. i didn't feel like i had the ability to do or say anything else at the time. per our school policies, i informed the clinical staff member who had been with us from school about what i had seen. i was thanked and assured the information would be forwarded on to the facility don.

has anybody had similar nightmare-ish clinical experiences, or have i just had bad luck so far? i don't want to learn the wrong way to do things. i want to learn best practices through hands on experiences, not just reading out of the book. has anybody else had this problem at clinicals?

[shannahan]

I'm finishing block 1 and don't feel we have a great clinical experience either so far. An instructor told us that anyone can be taught the specific skills, i.e. injection, catheter, etc. What is difficult is the nursing process and that is what we really have to learn in nursing school. There will be other chances and times to learn the specific skills (I hope anyway!) This makes sense to me so I'm not letting it worry me, that we aren't having the greatest clinical experience.

As far as seeing things done incorrectly, we tell our clinical instructor and let her do with it what she feels best.

[qaqueen]

Gosh, it seems soooo long ago that I was starting clinicals! Actually, it was less than two years ago. Some days I absolutely hated it. Some of my horror days included:

The catheter issue you mention, oh yeah, more than once.....

A nurse tearing the fingertip off her glove to feel for a vein, after cleaning the site with alcohol.

A nurse trying to use me as a sitter for a confused and critically ill pt.

Lots of rude nurses who are SO not interested in teaching.

A nurse I had to follow for 10 hours that would not speak to me, would not answer questions and actually slammed a door in my face.

Nurses using their teeth to uncap needles, open bags, etc..

My best suggestion, learn everything you can, the things that you will do AND the things that you wont do when you become a nurse.

Good Luck

[RNROSER2011]

You could look at the experience as a lesson in what not to do. I understand the feeling of being unwelcome in the clinical setting. My second semester was different, we were away from the SNF's in a med-surg setting. I found that a declaration of, "We're here to help you in any way" earned some good will. After a couple weeks, we got called for all the interesting cases and followed some of our patients to surgery, etc. Don't be too proud to do "CNA work", and you may be surprised at the results. There will always be the burned out individuals that don't wish to help the learning process, but don't stop trying to enhance your own experience.

[HJS27]

If you are not doing so already, you need to inform your clinical instructor of these issues. It is the clinical instructor's job to see to it that you receive accurate, adequate, ethical instruction. If he/she does not take appropriate action, you need to go up the chain of command for your school. The CI should also be coordinating with the floor manager/facility nursing manager as well. If you are seeing what you believe to be unsafe or unethical practices, it is your responsibility to report incidents to your CI. They can't change what they don't know about.

[OCD_Mom]

We are told that in nursing school we are taught to work in the "white tower" HOWEVER once you step outside the educational walls and into a practical setting we will see everything you are not supposed to do. Definitely bring things up with your clinical instructor but realize these people who do these things are not the health care provider you want to be. When witnessing these "wrongs" think about what should be done and what you would do if you were a fellow nurse...again protect the patient by notifying your instructor now, but I we were told to NEVER confront the clinical site nurses.